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The Print
21-07-2025
- Health
- The Print
Once brought in as ‘historic reform', National Medical Commission is showing same symptoms as predecessor
NMC comprises 33 members, a chairperson, 10 ex-officio members, and 22 part-time members. In addition, there are four autonomous boards to support its functioning—for undergraduate (UG) and postgraduate (PG) education, medical assessment and rating, and ethics and registration. What was considered the most appealing feature of the new medical education regulator was that its members would be 'selected' on the basis of 'merit'. New Delhi: In 2020, the constitution of the National Medical Commission (NMC) was hailed as a ' historic reform ' in the field of medical education and the practice of medicine. It replaced its predecessor Medical Commission of India (MCI), a network of elected representatives set up in 1933 and governed by Indian Medical Council Act, 1956, which had come to be viewed as a den of corruption, inefficiency and arbitrariness. 'Men and women with impeccable integrity, professionalism, experience and stature have been now placed at the helm to steer the medical education reforms further,' the Centre had said, announcing NMC's inception on 25 September, 2020. However, nearly five years later, a massive 'scandal'—involving senior NMC officials, some from the Union health ministry and a former University Grants Commission head—has been unearthed by the Central Bureau of Investigation (CBI), and many suspect it is just the 'tip of the iceberg'. The allegations being probed include unauthorised sharing of classified regulatory information, manipulation of statutory inspection processes, and widespread bribery to secure favourable treatment for private medical colleges—reminiscent of the MCI era. The episode has once again triggered passionate debates on the commission's functioning, with doctors and medical experts telling ThePrint that NMC has not been able to deliver on its promises. Many point out that NMC has been unable to successfully perform any of its stipulated 'key functions'—streamlining regulations, rating of institutions, raising focus on research, introducing a national licentiate examination after MBBS course, creating an all-India register of doctors, and preparing guidelines for fee regulation by private medical colleges. Neither has it been able to develop standards for Community Health Officers with limited practicing licence, and no MBBS degrees, providing primary healthcare services in rural areas, those in the fraternity rue. Additionally, many doctors anonymously express concerns about the growing influence of the RSS-backed National Medicos Organisation (NMO) on the functioning of the NMC, and the alleged religious agenda. Also Read: Health diagnostics is a game of 'molecules & money'. Amazon has just entered the race 'Bureaucratic & political interference' According to the previous national president of Indian Medical Association Dr R.V. Asokan, NMC was 'never meant to perform'. 'It was meant to be its master's voice, which it is. The expectation was that it should perform as an arm of the government, favouring medical colleges at the cost of quality in teaching and training, and promoting mixopathy and crosspathy (integration of modern medicine with alternative medicine), and it it faithfully doing it,' Dr Asokan told ThePrint. IMA—the largest network of doctors in the country—had fought tooth and nail against the constitution of the NMC, arguing that MCI was a democratic body duly elected by the entire medical fraternity of the country, and that it deserved a clean-up, not extinction. Dr Ravi Wankhedkar, another former IMA president, said that the only 'achievement' that the NMC can showcase is the massive expansion of UG and PG seats, and the number of medical colleges coming up at the cost of alarming dilution of infrastructure and faculty norms, and declining teaching standards. Government statistics show that India had 731 medical colleges offering 1,12,112 MBBS seats, and 72,627 PG or PG-equivalent seats in medicine in the 2024-25 academic session. According to health ministry data, this was a substantial hike from 387 colleges, 51,348 MBBS seats and 31,185 PG seats before 2014. 'But so poor is the quality of teaching and learning in medical colleges these days that we will be extremely wary about getting treated by the doctors passing out of the current system. I am really concerned about what happens to patient safety and healthcare services in this country once the new generation of doctors takes over,' Dr Wankhedkar told ThePrint. Yet, he added, the benefit that the government is getting out of this is that they can boast about opening medical colleges and increasing the number of seats in medicine to 'score political points'. Asked about the many such observations about the NMC, the body's outgoing chairman Dr B.N. Gangadhar told ThePrint that while he respected his colleagues' opinion, given that the expectations from the commission were huge, it had done a 'reasonably fair job thus far'. 'Several changes have been brought out, including massive expansion of medical colleges, number of UG and PG seats. Implementation of these changes will take time. It's all a work in progress,' he said. Incoming NMC chairperson Dr Abhijat Sheth, appointed last week, is set to take charge soon. Dr Gangadhar also described the announcement of new teaching recruitment norms this month, allowing specialists in non-teaching hospitals to be able to work as teachers, as a move aimed at correcting the biggest problem plaguing the sector—faculty shortage. But many have argued that this will further dilute teaching training standards. A senior NMC functionary, whose term ended two years ago, confirmed the assessment that others in the medical fraternity have made. 'We tried to do many things, but the bureaucracy harassed us like anything. The intent of setting up NMC was right, but the way things are, I see little hope. There is too much political and bureaucratic interference,' said the ex-NMC member, requesting anonymity. ThePrint also reached Union Health Secretary Punya Salila Srivastava via email for a comment on these allegations. This report will be updated if and when a response is received. 'Reforms' that turned out to be non-starters The NMC Act of 2019 had envisaged the National Exit Test or NExT as a singular qualifying examination to replace three existing exams in the field of medicine—the final MBBS exams, the National Eligibility-cum-Entrance Test for PG seats (NEET-PG), and the Foreign Medical Graduate Examination (FMGE) for foreign graduates to practice medicine in India. The Act had stated that qualifying in NExT would be a must—within three years of the Act getting notified—for every MBBS graduate to receive a licence to practice medicine in the country. Later, in 2023, the NMC had announced that from 2024 onwards, the NExT exam would be conducted twice a year, only to face stiff resistance from medical students across India forcing the regulator and the government to put the idea on hold. In a representation to the government in 2023, the IMA had said that the group, along with various networks of medical students, rejected NExT in toto for its 'anti-student content'. In January last year, the NMC sought public feedback on the feasibility of the test, indicating that it was unsure about the basic premise of the test. There has been no word on the fate of this proposed examination since. In 2022, the commission had ruled that private medical colleges in India will have to keep the fee for half the seats at par with that charged by government colleges in the respective states they are located in. This had come amid concerns that fee for MBBS seats at a private medical college in India could range between Rs 10 lakh and Rs 30 lakh a year, meaning that students would have to shell out anywhere from Rs 50 lakh to Rs 1.5 crore for the duration of the course. This move was, however, challenged in different high courts and the Supreme Court, and was stayed and never implemented. Another key task of creating a national medical registry (NMR), meant to create a database of credentials and details of the nearly 13 lakh doctors practicing in the country, has also been struggling to take off. Over the last five years, the database has been able to register just about a few hundred doctors, with most doctors in even metro cities yet to be registered on the portal, NMC sources said. 'I feel that the MCI-Board of Governors (BoG) that had been put in place after dissolution of the MCI was at least able to carry out certain measures. NMC has fared poorly on many counts,' said Dr Satendra Singh, professor of physiology with the University College of Medical Sciences, Delhi. MCI-BoG—headed by Dr V.K. Paul, member-health, NITI Aayog—which worked on an interim basis for two years between 2018 and 2020, had brought in plans like district residency programme (DRP) scheme, and allowing private hospitals to start PG-equivalent courses that were later implemented by the NMC. Worse still, Dr Singh said, the commission has so far not even been able to ensure implementation of the competency-based medical education (CBME) curriculum across the country, mandatory under the World Federation for Medical Education's (WFME) Global Standards for Quality Improvement: Basic Medical Education, 2020. Established by an initiative of the World Health Organisation and the World Medical Association, the WFME had awarded recognition status to the NMC for 10 years in 2023. Also Read: Bringing dramatic drop in TB deaths, how TN set an example for rest of India with one-of-a-kind model Series of U-turns In September last year, NMC was forced to amend its contentious CBME guidelines after vehement protests by activists who called the guidelines 'outdated' and 'archaic'. The 2024 guidelines for the undergraduate forensic medicine curriculum were set to replace the 2019 guidelines in the upcoming academic session, and apply to one lakh medical students across universities in the country. Those who opposed the guidelines, however, underlined that the guidelines deemed 'lesbianism and sodomy' as unnatural sexual offences, clubbing them with sadism, necrophilia and voyeurism. This was not the first time that the NMC had gone back on a decision, which was being publicised as a 'reform'. A similar controversy had erupted in 2023 when the body had mandated doctors to prescribe generic drugs or face penalties, forcing it to put the professional conduct regulations on hold. The same year, after strong protests from southern states, the NMC had deferred its decision to set up more MBBS colleges, and add more UG seats based on the population of different states. 'The number of corrigendums and addendums that the NMC has published over the last few years is higher than what the MCI published in the over seven decades that it existed,' Dr Singh said. 'It shows how this body is functioning—without the required seriousness and vision that are absolute must.' The regulator, he stressed, has turned out to be 'old wine in a new bottle with little action that matters, and a master of U-turns that put a question mark on its credibility'. He also pointed out how the body has been working on an ad-hoc basis for the last two years. Dr Gangadhar, former director of the National Institute of Mental Health and Neurosciences, Bengaluru, who had been the chairman of the commission's Medical Assessment and Rating Board since 2020, was appointed as officiating NMC chairman in 2023, when the term of its first chief Dr S.C. Sharma ended. In July last year, he was appointed as NMC chairman, but the positions of whole-time members and chairpersons of three out of four boards at the commission have been lying vacant for nearly two years, though several whole-time and part members of NMC were selected through a draw of lots by Health Minister J.P. Nadda last week. Besides the new chairperson, name of the new president of the medical assessment and rating board was also announced on 11 July. 'If the medical education regulator has to be run with a draw of lots, why not even choose our parliamentarians like that?' remarked Dr Asokan. He added that while there were issues with the way MCI had been functioning, mainly as too much power was vested with one person, it at least ensured that 'ruthless standards' were maintained in colleges leading to Indian doctors making their name world over. The former NMC member quoted earlier said that 'quality people' were reluctant to work with the commission, given the tight bureaucratic control. Influenced by NMO's ideology? In 2022, NMC had made it compulsory for every medical college to have a 'Department of Integrative Medicine Research' to promote integration of modern medicine with homoeopathy and Indian systems of medicine, such as Ayurveda. In December 2023, a section of doctors had protested strongly against the change in the logo by the commission, calling it a move aimed at 'altering' the 'secular' face of the government agency. The new logo had a colorful picture of Dhanvantari, recognised as the physician of the gods in Hinduism, and called the 'God of Ayurveda' in some religious texts. In April this year, the regulator had ruled that offering medical duty during the Char Dham Yatra in Uttarakhand would be counted as part of the District Residency Programme—a mandatory requirement for PG students to serve for three months in district hospitals or district health systems. 'These decisions have largely been due to NMO's line of thinking, which many in the medical fraternity now believe has too much influence on the commission's policy decisions,' said a doctor and faculty member at a medical college in Delhi, requesting anonymity. However, Dr Gangadhar dismissed these concerns. He said that the adoption of the logo followed a collective decision by NMC members after the idea was floated by a local IMA president from Maharashtra. 'The idea to include Char Dham Yatra in DRP for colleges across the country came after wide consultation within the commission, but a particular group associated with an organisation from some colleges decided to follow it,' he clarified. On the claims that the commission is actively promoting crosspathy—a term he said he does not agree with—the outgoing chairman maintained that the idea exists in the NMC Act itself. 'The (NMC) Act itself says that multiple boards (of different streams of medicine) should be meeting and discussing with an open mind as to what is needed and can be done. We are just following these provisions. Otherwise, the Act itself should be scrapped,' he remarked. (Edited by Mannat Chugh) Also Read: Govt tightens drug billing norm for CGHS claims. What new rule is & why pvt hospitals are pushing back
The Hindu
20-06-2025
- The Hindu
Drive against footpath encroachments every Saturday
The Greater Hyderabad Municipal Corporation is going to begin a weekly drive against footpath encroachments, especially by the commercial establishments. A circular has been issued to this effect by Commissioner R.V. Karnan on Thursday, which said the drive should be conducted every Saturday. Issued to Zonal and Deputy Commissioners and marked to the Chief City Planner, Additional Chief City Planners, and the City Planners, the circular also directed for the drive to be carried on a minimum of one stretch per circle every week, in a joint operation with the Traffic Police as part of the 'Operation ROPE' (Removal of Obstructive Parking & Encroachments). Under Operation ROPE, a large number of hawkers and vendors are already being removed from the road margins and footpaths. Recently, the displaced hawkers conducted a demonstration in front of the GHMC corporate office, demanding that the harassment be stopped. MLA Akbaruddin Owaisi, during a meeting, raised this issue and questioned if the GHMC wanted the vendors to become pickpockets. Officials assure that the new phase will not target the vendors but the commercial entities which occupied footpaths to install their extensions such as steps, sign boards, kiosks, poles and other such impediments. They are invoking the powers of the GHMC Commissioner under Section 405 to remove obstructions on the street, drain, channel etc. The objective is stated as having ease of traffic movement and facilitating pedestrian movement on footpaths. This is not the first time GHMC is taking up such a drive. A similar drive was taken up after establishment of Enforcement, Vigilance & Disaster Management wing as part of GHMC, in 2018. Armed with excavator machinery, the EVDM personnel destroyed not mere sign boards, but even the ramps and steps built onto the road & footpath portions. However, no attempt was made to build footpaths or roads on the reclaimed space. After a while, the shop owners rebuilt the steps or started using iron ladders instead.
The Hindu
13-06-2025
- Entertainment
- The Hindu
Silent fall of single-screen theatres in Andhra
The narrow lane outside Navarang Theatre in Vijayawada's Governorpet was once abuzz with taxis and autorickshaws that brought an excited audience. On billboards, large posters caught the movie cast in the thick of action and drama, and in the air, hung faint snippets of dialogues and music wafting out from the hall. Opened in 1964, Navarang Theatre was a cultural landmark, where rickshaw pullers and taxi drivers took pride in watching Hindi and English movies alongside the city's elite. Blockbusters ran for months, with word of mouth doing its magic. Today, however, silence has shrouded the theatre, its empty seats and faded walls a stark contrast to the housefulls in its heyday. Navarang Theatre is one of the last few independently run single screens in Andhra Pradesh. Most of its contemporaries, including the State's first theatre Maruthi Talkies, Vijaya Talkies, Sri Durga Mahal, Mohan Das, all in Vijayawada, have shuttered, while many others have either leased out their theatres or rented them out as real estate properties. The decline began decades ago, when televisions became commonplace in households. Then came the internet revolution, the smartphone penetration and, finally, the proliferation of OTTs. These, along with an 'unreasonable' revenue-sharing model between distributors and exhibitors seem to have finally broken the back of this once-prosperous industry. Rolling with the punches For Navarang Theatre proprietor R.V. Bhupal Prasad, its 'passion' that keeps him in the business. His family used to own 13 theatres, including Saraswati Talkies, Saraswati Picture Palace, Leela Mahal and Navarang, across the State. Leela Mahal, which opened in Vijayawada in 1944, was the first theatre in the Andhra region of the Madras Presidency to screen English and Hindi movies. Today, he agonises over which movie to screen. 'It is exhausting; we don't know which movie will strike a chord with the audience. Sometimes, even a big-starrer tanks at the box office, and sometimes, a small movie makes waves,' he says. In a 2021 research paper titled Amplification as Pandemic Effect: Single Screens in the Telugu Country, authors S.V. Srinivas, a professor of literature and media studies at Azim Premji University, Bengaluru, and Raghav Nanduri say that around 90% of single-screen theatre owners in Andhra Pradesh have leased out their theatres. Dwindling business is one reason why they did it. 'These days, pirated copies reach one's smartphone even before the film's release. Why would anyone want to incur losses? So, they lease the theatre out to those who have the wherewithal to run it. That guarantees a stable income. These days, running a supermarket makes more sense,' says a veteran exhibitor, who sought anonymity. Across A.P. and Telangana, over 600 independently run single screens are haemorrhaging money. Srinivas, one of the authors of the research paper, says that leasing has helped single screens survive. 'Under the lease system, where most lessees are bigshots in the industry, many single screens were renovated and received a multiplex feel. Moreover, re-releases, too, have become the lifeline for many theatres.' However, some in the business feel that small producers find it difficult to get their films released in theatres run by these bigwigs. On expenses, the veteran exhibitor explains that around ₹20,000 a day is needed to run a single screen in a city such as Hyderabad or Visakhapatnam. In smaller cities, it could be around ₹15,000. The power bill comes around ₹2.5 lakh a month and staff salary around ₹1.5 lakh. 'If we get ₹4 lakh a month, we can break even, but we rarely get it.' While Kamal Haasan's 2022 movie Vikram fetched him ₹7 lakh in the first week, the same actor's recent movie Thug Life barely scrapped together ₹7,000, opening to a 6% occupancy rate in his theatre. 'I incurred a loss of ₹3 lakh over the past four months,' he adds. Revenue sharing model While decreasing footfalls, piracy and OTT platforms are problems faced by multiplexes, too, their situation is slightly better, say some single-screen owners. And it is here, in the difference, that the chief concern of exhibitors comes to the fore: the revenue-sharing model. To understand the revenue-sharing model between the exhibitors and distributors, it is important to know how the system of buying-distributing-selling of a film works. 'The concept of exhibitor-distributor existed since the first movie,' says Grandhi Viswanath, who has nine single-screen theatres across the State. His grandfather, G.K. Mangaraju, became the first distributor and exhibitor in the State in 1927, when silent movies gave way to talkies. His distribution office, Poorna Pictures, is the first distribution company in the State. 'Earlier, it was a healthy system. A producer would inform the distributor about a new movie. A distributor would look at the casting, content and production cost and then invest in the movie to buy the rights. There used to be one distributor for an entire region for that particular film. The distributor would have links with a few theatre exhibitors, to whom the print of a film would be handed over. The ticketed revenue was shared on a percentage basis between a distributor and an exhibitor,' he explains. Because only one or two theatres screened a film, it would have a good run. The A. Nageswara Rao-starrer Devadasu ran for 140 days in Vijayawada's Maruthi Theatre, the State's first theatre opened in 1921. Now, however, old established distribution companies have been replaced by 'buyers'. Mr. Srinivas and Nanduri, in their research paper, say: 'These buyers could be anyone with the capital to bid for distribution rights. Typically, buyers would bid competitively, and speculatively, for rights in a single-distribution territory, resulting in substantial gains for producers of big-budget star vehicles.' According to some film exhibitors, the entry of these buyers heralded the downfall of their industry. Mohan (name changed), an exhibitor, says there is a distributor for every district now, and that person ensures that the film is released on all the screens across that district. 'These days every new movie is screened simultaneously on all the screens. When the audience is spread among so many theatres, the chances of a theatre seeing a housefull dwindles; the audience thins out on the second day itself,' he adds. Moreover, these days, the new-age distributors help producers finance big-budgeted films. The distributors collect half the amount the producer requested from theatre owners. If the film fares well, the producers give back the advance amount to distributors, who, in turn, give it back to exhibitors. If the movie is a flop, then exhibitors do not get their money immediately, according to some exhibitors. This has resulted in exhibitors' money getting blocked for a long time. Depending on the locality and the film's potential, the advance may range anywhere from ₹5 lakh to ₹40 lakh. This, in addition to the current revenue-sharing model, has crippled single-screen theatres in the State. 'The distributors decide on the revenue sharing unilaterally. In the first week of the theatrical release of a movie, the distributors either give us a rent or a percentage system, whichever gives them more profit. If the movie is a hit, the distributors give us a rent. If it's a flop, they offer a percentage,' says Mohan. The way forward In May, film exhibitors in Andhra Pradesh and Telangana announced that they were not in a position to continue to screen movies. Mohan says that one of their chief demands is that the ticketed revenue be shared on a percentage basis, like how it is in multiplexes and other States. 'The percentage model can solve some of our problems,' he feels. According to the research paper, single-screen theatres continue to be important for box office collections and contribute up to 60% of ticketed revenue. Despite this stature, no new single-screen theatre has come up in the two Telugu States over the past decade, says the veteran exhibitor. Mr. Grandhi Viswanath feels that along with the overhaul in the revenue sharing system, the government should allow flexible admission rates (ticket prices) as well. Currently, ticket prices in the State are fixed in accordance to the Government Order (G.O. issued on March 7, 2022. In this order, the government had fixed rates for different type of theatres in municipalities and corporations. 'The exhibitors should be given the discretion to decide on the admission rate (ticket price) of a movie, depending on its potential. This will help get more patronage for smaller movies,' he says. Echoing this, Chandrasekhar (name changed), another exhibitor, points out that the exorbitant production costs of a film leads to higher ticket prices. Once a moviegoer spends ₹250 a ticket for a big-budget movie, they may not see another film in a theatre for, say, a month. 'Smaller movies, released after the big-budget movies, often get killed thus. The theatres, too, hence do not see much footfall,' he says, adding that the government should also ensure that a movie is released on the OTT platform eight weeks after the theatrical release. Chandrasekhar says that theatre owners like him never called for a bandh. 'It is unfortunate that we were misinterpreted; we only want to request the government to consider our demands for a percentage system, which will allow us some breathing space. After all, our goals are the same, to bring back audience to the theatres.' What distributors say A distributor in Visakhapatnam, who sought anonymity, says it's the distributor who stands to lose more than an exhibitor when a movie flops. 'The success rate these days is 6%. We invest in a movie and we lose when it flops. The exhibitors do not have anything to lose. They can at least benefit from parking charges. The advance amounts that they have to part with are immediately returned.' To the exhibitors' demand for implementation of a percentage system (for all the weeks), he said this would be disadvantageous for distributors. Responding to the exhibitors' concerns, Telugu Film Chambers of Commerce president Bharath Bhushan says distributors, too, are facing problems. The whole issue stems from a dearth of hits in the industry. 'A flop movie is a death knell for everyone' The Telugu Film Chamber of Commerce has formed a committee of 30 members, comprising distributors, exhibitors and producers, to work out a solution amenable for all. The report is expected soon. Bharath Bhushan says a decision regarding the demands would be taken after a meeting with the stakeholders on June 23 and 24. After A.P. Deputy Chief Minister K. Pawan Kalyan emphasised the need for regulating cinema halls properly across the State and keeping food, beverages prices reasonable, many are hoping for a positive outcome from these meetings.
